Comments and Suggestions Form

Please fill in this form to send a message to our staff who will adhere to reply within 48 hours. If this form is completed after 4pm ,it will be actioned on the next working day.Alternatively, please download the Rotherham Health App and use the symptom checker. Thank you.

What kind of comment would you like to send? Remember this form is not for medical matters.
Your comment is:	Please choose an option A Suggestion Praise Regarding a Problem Other
What would you like to say?
Enter your comments in the space below

Your contact details
Your Name:
Your Email:
Your Telephone:
Do you agree to be contacted regarding this matter?
Yes, I agree that the practice may contact me regarding this matter
Recaptcha:

About This Form

Note that by using this form, you will be sending information about yourself across the Internet. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method to notify us of your comment.

Your IP address (3.133.128.227) will be sent with your communication. In rare cases where abuse or criminal activity can be shown to have taken place this may be used by the authorities to trace you.